AMA meeting: Study to gauge impact of recertification on doctors

Chicago The House of Delegates directed the American Medical Association to take several steps to look at the maintenance-of-certification process and ensure that it is not burdensome to physicians.

The AMA will commission an independent study to evaluate the impact that MOC and maintenance-of-licensure requirements have on physicians' practices, the doctor work force and patients. A progress report on the study will be presented at the 2014 Annual Meeting.

The Association also will work with the American Board of Medical Specialties and its specialty boards to determine if the mandatory exams still are needed and to explore alternatives to the exams. The house directed the AMA to encourage the ABMS to ensure that its member boards are transparent about the costs of preparing and administering certification exams.

Robert Hughes, MD, a delegate and immediate past president of the Medical Society of the State of New York, called the house's action a step toward improving the certification process.

“It's looking at the process and attempting to come up with a fair solution,” said Dr. Hughes, an otolaryngologist from Queensbury.

Some delegates said MOC is expensive, time-consuming and at times not pertinent to the physician's practice. They said doctors need to fulfill continuing medical education requirements, and there is no evidence that being board certificated means someone is a better physician.

“If I see 15 patients every day, I'm taking 15 tests, and I need to get an A on every one of them,” said Leah McCormack, MD, a New York delegate and past president of the MSSNY. Dr. McCormack, a dermatologist from Forest Hills, called the requirements onerous and an insult to physicians.

Dr. Hughes said patients usually don't know if their doctor is board certified.

Some delegates said recertification exams should not be mandated for hospital credentialing, a position that aligns with existing AMA policy opposing mandatory board certification.

Exams take time and money

Several delegates said that although doctors must prove their competency, it doesn't have to be done through stressful and burdensome exams.

Brigitta Robinson, MD, a Denver general surgeon who spoke on behalf of the Colorado Medical Society, expressed concern about the cost and travel time involved in taking the exams, which often are administered in another state.

Carol Berkowitz, MD, a member of the AMA Council on Medical Education and a delegate for the American Academy of Pediatrics, said she doesn't believe the AMA has the authority to make mandates to other bodies. She spoke against a proposal to require the ABMS and other agencies and boards to wait until after the progress report on the exams' impact is presented at the 2014 Annual Meeting before having physicians sit for MOC exams. (See correction)

Others disagreed, saying they don't want the AMA to lose control to other entities.

“The power in this [policy] is that the AMA has tremendous weight in terms of advocacy and public opinion,” said urologist Joseph Maldonado, MD, a New York delegate and vice president of the MSSNY.